The Self-Pressurising Air-Q® Intubating Laryngeal Airway for Airway Maintenance during Anaesthesia in Adults: A Report of the First 100 Uses

Abstract

The self-pressurising air-Q ® Intubating Laryngeal Airway is a new, commercially available, supraglottic airway device that incorporates a self-regulating periglottic cuff. In this retrospective review, we describe our initial clinical experience using the device in 100 patients. The ease and number of insertion attempts, airway seal pressure, device positioning, intubation success and oropharyngeal morbidity were recorded. The air-Q Intubating Laryngeal Airway was successfully inserted in all 100 patients and functioned adequately as a primary airway in 70 of the 72 patients in which it was used for this purpose. The median (interquartile range [range]) airway seal pressure was 22 (19-29, [10-40]) cmH 2 O. Intubation via the air-Q Intubating Laryngeal Airway was successful in 28 of 29 (97%) patients. Eleven percent of patients complained of sore throat postoperatively before discharge. In our series, the air-Q Intubating Laryngeal Airway performed adequately as a primary airway during anaesthesia with respect to ease of insertion, adequacy of airway maintenance and as a conduit for intubation in both anticipated and unanticipated difficult airways. Although our initial experience is positive, further investigation with larger numbers of observations are needed as the upper limits of the 95% confidence intervals for device failure (the worst failure rate the clinician could expect) are still high.

Self-pressurized air-Q® intubating laryngeal airway versus the LMA® Classic™: a randomized clinical trial

“…12 The first-attempt insertion success rates were similar with both devices, as has been shown previously in adults and children. 12,15,16 The flexible bronchoscopic fields of view through the air-Q SP were superior to those through the LMA Classic as reported previously. 12,15 Nevertheless, the relationship between the field of view and function of the device, including the airway seal, remains obscure.…”

“…Nevertheless, we surmise that the superior bronchoscopic view with the air-Q SP suggests that it can serve as a reliable conduit for tracheal intubation and so would be useful in a ''difficult intubation'' situation. 16,26 Moreover, the air-Q SP's design has been shown to help position the endotracheal tube at a correct depth in the trachea. 27 When the LMA Classic is overinflated, it can result in laryngeal mucosal damage and ischemia, resulting in sore throat, neuropraxia, regurgitation, and arytenoid dislocation.…”

“…11 Previous studies have shown the efficacy of the original air-Q as an airway maintenance device 12 and as a tracheal conduit for pediatric and adult patients. 13,14 Nevertheless, the only comparative study of the air-Q SP and other SGAs was performed in children, 6,15 and while its performance in adults has been described 16 there are no head-to-head comparative studies in adult patients.…”

A randomized comparison of the i‐gel™ with the self‐pressurized air‐Q™ intubating laryngeal airway in children

“…In addition, there have been controversial results regarding optimal intracuff pressure in various types of cuffed supraglottic airways . In this regard, supraglottic airway devices with noninflatable cuffs have advantages in omitting the cuff pressure monitoring and reducing potential pharyngolaryngeal complications . Typical devices without cuff inflation available for children are the i‐gel ™ (Intersurgical Ltd, Workingham, UK) and the self‐pressurized air‐Q ™ intubating laryngeal airway (air‐Q SP, Cookgas LLC; Mercury Medical, Clearwater, FL, USA) .…”

Extraglottic airway devices: A review

“…Air Q/ILA's performance was adequate as a primary airway during anesthesia with respect to ease of insertion, adequacy of airway maintenance and as a conduit for intubation in both anticipated and unanticipated difficult airways. [76] Another study showed that the FT-LMA had a higher rate of success (99%) in facilitating blind intubation than did the Air/Q ILA (77%) [Figure 14]. [47]…”